EPIC Seminar: Expertise, Lived Experience and Legal Processes

 Sheelagh McGuinness reports from an EPIC seminar in February 2026.

In February 2026 EPIC hosted the first in a series of seminars examining the relationship between legal processes and epistemic injustice. The event brought together researchers from philosophy, law, and social science to consider how legal and regulatory frameworks can exacerbate or ameliorate the epistemic marginalisation of those who engage with them.

Professor Lisa Bortolotti (EPIC/University of Birmingham) opened with a conceptual analysis of expertise and its relationship to epistemic injustice, arguing that expertise should be understood both in terms of the knowledge an individual possesses and as a form of performance in a particular environmental context. An agent may hold relevant expertise yet be unable to exercise it if the conditions necessary for effective performance are not in place. Examples include not being invited to contribute, if space constrains or excludes their perspective, or if their testimony is challenged or reframed without genuine engagement.

Bortolotti paid particular attention to experts by experience, focusing on people with lived experience of mental health services participating in healthcare research. She identified three stages at which such expertise may be obstructed: exclusion from participation entirely; inclusion on terms that do not permit meaningful contribution; and formal inclusion accompanied by insufficient uptake of testimony. Each stage, she argued, can be understood through existing concepts in the epistemic injustice literature, including participatory injustice and testimonial injustice.

You can read more about this research here.

Dr Lucy Series (University of Bristol) introduced the labyrinthine world of mental health and mental capacity law, offering an account of how lived experience has (or has not) shaped these frameworks in England and Wales. Series’ presentation began by outlining the commonly accepted distinction of mental health law as a coercive instrument and mental capacity law as a more benign mechanism for substitute decision‑making in a person’s best interests. She proceeded to detail the ways in which this distinction is inaccurate. In particular, she highlighted how the 2005 Mental Capacity Act can in practice authorise detention and involuntary treatment and often with fewer procedural safeguards than those available under the 1983 Mental Health Act.

Series traced the involvement of disabled people and mental health service users in shaping these legal frameworks over several decades. She concluded by considering the relationship between legal complexity and genuine participation. Where legal frameworks are highly technical and their implications difficult to foresee, consultation processes that do not invest in participant understanding risk generating outcomes that diverge sharply from what advocates intended. She closed by asking what structural conditions are necessary for expertise by experience to be genuinely incorporated into legal and regulatory processes.

The final presentation applied the conceptual frameworks outlined in earlier presentations to empirical research on bereaved families' experiences of two distinct legal processes: coroner's inquests and fitness to practise hearings. Professor Sara Ryan (Manchester Metropolitan University) presented findings from research with family members who had engaged with these processes following healthcare-related harm, including the deaths of relatives with learning disabilities or autism. You can read more about this research here.

Families reported entering these processes as relative novices, surrounded by professionals whose familiarity with procedural norms gave them significant epistemic advantage. Families were expected to provide instruction without understanding what that meant procedurally, leading to a form of disconnection that Ryan characterised as epistemic marginalisation. The fitness to practise hearings produced comparable difficulties including:

• witness statements were altered or reduced in scope without notification
• charges were revised between referral and hearing
• participants who had prepared to give evidence were informed at very short notice that their testimony was no longer required.

Some participants stated that they would not make a referral again and one described the fitness to practise process as more distressing than the bereavement itself.

Ryan concluded by emphasising how modest reforms, for example, clearer communication, named contacts, and acknowledgement of the person who died as an individual have the potential to meaningfully ameliorate epistemics injustices.

The event offered compelling insights into how epistemic injustice operates across healthcare, law, and regulatory practice. A consistent pattern emerged across all three contexts (through the obstruction of expertise by experience in clinical settings, the failure of legal frameworks to meaningfully incorporate the perspectives of those they affect, and the systematic marginalisation of bereaved families in coronial and fitness to practise processes). The people with the biggest stake in these processes are routinely denied the epistemic standing to influence them. Addressing this requires not only conceptual clarity about what epistemic justice demands but also sustained attention to the structural and institutional conditions that make genuine participation possible.

Sheelagh McGuinness

Sheelagh McGuinness is professor of law at the Centre for Health Law and Society, University of Bristol. Her research interests include the regulation of reproduction, and health law more generally. Sheelagh is currently a co-investigator on two projects: Epistemic injustice in healthcare funded by the Wellcome Trust and Reproductive Borders and Bordering Reproduction (RBBR): Access to Care for Women from Ethnic Minority and Migrant Groups funded by the AHRC. Sheelagh is a member of the Board of Trustees of the British Pregnancy Advisory Board (BPAS). 

The Role of Silence and Music in Philosophy

On 16 March 2026, members of the EPIC team were joined by researchers, musicians, and members of the public for an evening of philosophical contemplation, music, and meaningful silence. The event, held at St George’s, Bristol, invited guests to consider what role silence plays in music, philosophy, and everyday life. Opening the event, music therapist and NIHR doctoral student (Hull York Medical School), Kate Binnie, led guests in a moment of collective silence, prompting reflections on how silence can create space for self-knowledge as well as support deeper social connections.

Echoing these ideas, in particular the therapeutic, and sometimes necessary, role of silence both individually and interpersonally, philosopher and EPIC research fellow, Dr Dan Degerman, provided an opportunity to consider the implications of ‘breaking’ silences, particularly in the context of mental health. Degerman emphasised that, while in many cases creating opportunities for discussion around experiences of mental illness can help reduce stigma, these discourses also risk framing silence as inherently harmful or negative. 

To remedy this, Degerman proposed ways of disambiguating different types of silence, introducing two key concepts, namely, literal and metaphorical silence. Literal silence being the absence of sound when nothing is said, and metaphorical silence referring to the absence of speech when something could, or indeed ought, to be said. Degerman explained that both kinds perform an important function in everyday interactions with others, yet only some are taken to be meaningful or welcomed silences, whereas others can create discomfort. That is, whereas some shared silences can facilitate a sense of closeness, mutual understanding, and intimacy, others create ambiguity that can be experienced negatively.

Taking up the invitation to reflect on the communicative and deeply embodied role of silence, Bristol Schola Cantorum performed a piece illustrating in practice how silence and music – like two sides of the same coin – shape the way we experience sound and its absence. Joining in the discussion, University of Bristol music scholars, Professors Emma Hornby and John Pickard offered their perspectives on the role of silence in musical performance and composition, prompting reflection on the breath and the careful placement of silence in orchestral performances.

Drawing these perspectives together, speakers and panellists, including philosopher of language, Dr Anthony Everett, and EPIC Principal Investigator, Professor Havi Carel, engaged in a thought-provoking panel discussion spanning tensions in conceptualisations of silence in the West and East, and its utility – or perceived lack of – in Western analytic philosophy, to its role in palliative care. Each of these perspectives provided avenues for reflecting on the role of silence in different contexts, including healthcare, highlighting tensions between the silence that occurs when no further speech is needed and the silence that emerges as a result of communicative failures between practitioners and patients.

In my experience, the invitation to reflect on silence prompted thoughts about voluntary and non-voluntary silences, particularly in the context of my own research on the COVID-19 pandemic and the measures used to control it. While for some, the silence that followed periods of national lockdowns and widespread closures of busy, otherwise noise-filled environments was experienced as a welcome break, for others, the (relative) absence of noise, and perhaps in particular the absence of other people, was deeply distressing. That is, while silence can bring a sense of peaceful solitude in some cases, in others it can amplify feelings of social isolation and loneliness.

Hence, not only did the event provide a space to reflect on the role of silence in music and philosophy, but it also provided opportunities to reflect on silence more generally. The significance of this is especially pertinent in times of widespread upheaval and crisis, like pandemics, but also other kinds of crisis, such as war and conflict, where silence as an absence of sound could be reconceptualised as a privilege not all have access to. Overall, while silence exists in many forms, its role in society, and its seemingly neutral or passive nature, can mean it is taken for granted, and yet its significance extends beyond its communicative function – it is in many ways a way of being and relating to others and the environment of which we are a part.

Author bio

Kathryn Body is an early-career researcher working at the intersection of the medical humanities, public health policy, and qualitative health research. She has a Master’s degree in Medical Law and Ethics from King’s College London and recently completed her PhD in the Department of Philosophy at the University of Bristol. Kathryn’s PhD research analysed online qualitative survey data on the COVID-19 pandemic in the UK, Japan, and Mexico, with a specific focus on embodiment and other aspects of subjective, lived experiences that came to the fore during that time. Currently, Kathryn is working as a part-time research assistant in the Anthropology Department at University College London, on a project exploring the biosocial impact of multiple caregivers in the lives of children and young adults, with a particular focus on mental health and wellbeing.